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Fulltext Development and Validation of a Questionnaire Assessing the Perception and Practice of Workplace Violence Prevention Among Employers at Healthcare Facilities in North-Eastern Malaysia

Mohamad Yazid MN, Nik Husain NR, Daud A, Osman Y, Mustapa N, Abdul Hadi A

Cureus, 2023 Jan;15(1):e34046.
PMID: 36824545 DOI: 10.7759/cureus.34046

Introduction Healthcare workers have been suffering from workplace violence in alarming numbers, showing the importance of its prevention initiative. This study aims to develop and validate a new questionnaire to assess the perception and practice scores of workplace violence prevention among employers at healthcare facilities. Methods Existing literature has been reviewed to establish the domains and refine the items. The first drafted domain was the perception constructed by six components and 59 items. The second drafted domain was practice, consisting of six components and 41 items. Content validation was measured by a panel of experts using the item-level content validity index (I-CVI). Then, face validation analysis was carried out among 10 healthcare employers and presented as the item-level face validity index (I-FVI). Lastly, 222 participants were recruited to determine the validity and reliability of the questionnaire by using an exploratory factor analysis (EFA) and internal consistency reliability. Results Following content validation, two items in the practice domain were removed because of the I-CVI below 0.78. The I-CVI values of the remaining items for both domains were above 0.78, indicating good relevancy of 59 items to assess the perception and 39 items to evaluate the practice domains. The I-FVI values for both domains were above 0.80, suggesting that the participants easily understood the questionnaire. Bartlett's test of sphericity was significant for both domains (p<0.001). The Kaiser-Meyer-Olkin measure was 0.879 for the perception domain and 0.941 for the practice domain. All items load above 0.6 in their respective factor. In addition, Cronbach's alpha coefficient of reliability test ranged from 0.71 to 0.92 and from 0.82 to 0.97 for the perception and practice domains, respectively. The final revised questionnaire consisted of nine components (35 items) for perception and four components (27 items) for practice. Conclusion The newly developed set of questionnaires is a valid and reliable tool to assess the perception and practice of workplace violence prevention among employers at healthcare facilities.
Fulltext An Association Between Job Stress and Poor Social Support Among Healthcare Workers in Northeastern Malaysia

Ab Aziz WA, Musa KI, Ibrahim MI, Osman Y, Shafei MN

Cureus, 2023 May;15(5):e38937.
PMID: 37313064 DOI: 10.7759/cureus.38937

INTRODUCTION: Job stress is an important occupational health problem globally. Hence, identification of workers at risk of developing job stress is paramount to the decision-makers. This study aims to estimate the proportion of job stress and its relationship with different categories of healthcare workers (HCWs) in the primary care and public health settings in northeastern Malaysia.
METHODOLOGY: A cross-sectional study involving 520 HCWs across all categories was conducted in Kelantan State, Malaysia. A proforma and validated Malay version of the Job Content Questionnaires were administered to obtain the data. The participants were then classified into four categories of workers according to Karasek's job demands-control model classification which were active, passive, high strain, and low strain.
RESULTS: We found that a total of 145 (28.5%) HCWs in the study have job stress (high-strain job type). HCWs with a degree or higher qualification had the highest proportion of job stress (41.2%), while the diploma group has the lowest proportion of job stress among the four academic qualification groups (22.9%). Pearson chi-square shows a significant association between Karasek's job types and the level of social support from their supervisors (p < 0.05) but no association between job strain and the level of supervisor's social support (p > 0.05).
CONCLUSION: Job stress among HCWs is prevalent, and the professional group had the highest percentage of risk job stress as compared to other groups. There is a significant association between the supervisor's social support and Karasek's job strain categories.
Fulltext Employers' Perception and Practice of Workplace Violence Prevention at Healthcare Facilities Questionnaire: A Confirmatory Factor Analysis

Mohamad Yazid MN, Nik Husain NR, Daud A, Osman Y, Mustapa N, Abdul Hadi A

Malays J Med Sci, 2023 Oct;30(5):192-205.
PMID: 37928796 DOI: 10.21315/mjms2023.30.5.16

BACKGROUND: Workplace violence prevention initiatives are undeniably lacking in healthcare facilities. The aim of this study was to validate a newly developed questionnaire and assess employers' perceptions and practices towards workplace violence prevention at healthcare facilities.
METHODS: A cross-sectional study was conducted from October 2021 to November 2021 by recruiting 333 employers at healthcare facilities in Kelantan, Malaysia. The original draft of the Malay version of the questionnaire comprised 62 items constructed under two domains (perception and practice). A confirmatory factor analysis was conducted to evaluate construct validity and internal consistency using R software.
RESULTS: The final model for the perception and practice domain of the questionnaire consisted of 13 factors and 56 items. The factor loadings for all items were above 0.6. The fit indices used for confirmatory factor analysis in the final model were as follows: χ2 = 2092.6 (P < 0.001), standardised root mean squared residual (SRMR) = 0.053, root mean square error of approximation (RMSEA) = 0.042, comparative fit index (CFI) = 0.928 and Tucker Lewis index (TLI) = 0.920. The construct reliability for all factors was reliable, with Raykov's rho coefficients above 0.70.
CONCLUSION: The newly developed questionnaire demonstrated excellent psychometric properties and adequate validity and reliability, confirming that this instrument is reliable and valuable for evaluating employers' perceptions and practices towards workplace violence prevention at healthcare facilities.
Fulltext The Impact of Heatwaves on Mortality and Morbidity and the Associated Vulnerability Factors: A Systematic Review

Arsad FS, Hod R, Ahmad N, Ismail R, Mohamed N, Baharom M, et al.

Int J Environ Res Public Health, 2022 Dec 06;19(23).
PMID: 36498428 DOI: 10.3390/ijerph192316356

BACKGROUND: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component.
METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework.
RESULTS: A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors.
CONCLUSIONS: While mortality and morbidity are critical aspects for measuring the impact of heatwaves on human health, the sensitivity in the context of sociodemographic, medical conditions, and locality posed a higher vulnerability to certain groups. Therefore, further research on climate change and health impacts on vulnerability may help stakeholders strategize effective plans to reduce the effect of heatwaves.
Fulltext Environmental and Occupational Factors Associated with Leptospirosis: A Systematic Review

Baharom M, Ahmad N, Hod R, Ja'afar MH, Arsad FS, Tangang F, et al.

Heliyon, 2024 Jan 15;10(1):e23473.
PMID: 38173528 DOI: 10.1016/j.heliyon.2023.e23473

BACKGROUND: Leptospirosis is a neglected emerging zoonotic disease with a profound public health impact worldwide with higher burden of disease in resource-poor countries. The environmental and occupational exposures contribute to human and animal transmission, but the interaction was less explored. A deeper understanding of the critical environmental and occupational drivers in different contexts will provide useful information for disease control and prevention measures.
OBJECTIVE: This review aimed to summarize the potential environmental and occupational risk factors associated with leptospirosis infection.
METHODS: Four databases (Scopus, Web of Science, Ovid MEDLINE, EBSCOhost) were searched for articles published from 2012 to 2021. Eligible articles were assessed using a checklist for assessing the quality of the studies. The quality of the articles was assessed based on the laboratory diagnosis approach and statistical analysis method.
RESULTS: A total of 32 studies were included in this systematic review. Water-related risk factors such as natural water as the primary water source (AOR 1.8-18.28), water-related recreational activities (AOR 2.36-10.45), flood exposure (AOR 1.54-6.04), contact with mud (AOR 1.57-4.58) and stagnant water (AOR 2.79-6.42) were associated with increased risk of leptospirosis. Infrastructural deficiencies such as un-plastered house walls and thatched houses presented a higher risk (AOR 2.71-5.17). Living in low-lying areas (AOR 1.58-3.74), on clay loam soil (OR 2.72), agricultural land (OR 2.09), and near rubber tree plantations (AOR 11.65) is associated with higher risk of leptospirosis. Contact with rats (AOR 1.4-3.5), livestock (AOR 1.3-10.4), and pigs (AOR 1.54-7.9) is associated with an increased risk of leptospirosis. Outdoor workers (AOR 1.95-3.95) and slaughterhouse workers (AOR 5.1-7.5) have higher risk of leptospirosis.
CONCLUSION: The environmental and occupational components related to water, infrastructure, landscape, agriculture, and exposed animals play an essential role in leptospirosis transmission. The magnitude of those risk factors differs with geographical region, climate factor, urbanization and population growth, and the country's socioeconomic status.
Fulltext Compliance to Infection Prevention and Control Practices Among Healthcare Workers During COVID-19 Pandemic in Malaysia

Mohamad N, Pahrol MA, Shaharudin R, Md Yazin NKR, Osman Y, Toha HR, et al.

Front Public Health, 2022;10:878396.
PMID: 35923958 DOI: 10.3389/fpubh.2022.878396

Healthcare workers (HCWs) are at risk of contracting coronavirus disease-2019 (COVID-19) in their workplace. Infection prevention guidelines and standard operating procedures were introduced to reduce risk of exposure and prevent transmission. Safe practices during interaction with patients with COVID-19 are crucial for infection prevention and control (IPC). This study aimed to assess HCWs' compliance to IPC and to determine its association with sociodemographic and organizational factors. A cross-sectional study was conducted between March and April 2021 at public healthcare facilities in the east coast of Peninsular Malaysia. HCWs who were involved with COVID-19-related works were invited to participate in the online survey. The questionnaire was adapted from the World Health Organization (WHO) Interim Guidance: WHO Risk Assessment and Management of Exposure of Healthcare Workers in the Context of COVID-19. Respondents were categorized as compliant or non-compliant to IPC. A total of 600 HCWs involved in COVID-19-related works participated in the survey. Most of them (63.7%) were compliant to IPC as they responded to all items as "always, as recommended" during interaction with patients with COVID-19. The multivariate analysis showed that non-compliance was significantly associated with working in the emergency department (AOR = 3.16; 95% CI = 1.07-9.31), working as laboratory personnel (AOR = 15.13; 95% CI = 1.36-168.44), health attendant (AOR = 4.42; 95% CI = 1.74-11.24), and others (AOR = 3.63; 95% CI = 1.1-12.01), as well as work experience of more than 10 years (AOR = 4.71; 95% CI = 1.28-17.27). The odds of non-compliance among respondents without adequate new norms and personal protective equipment training were 2.02 (95% CI = 1.08-3.81) more than those with adequate training. Although most of the respondents complied to IPC protocols, compliance status differed according to department, work category, and years of service. Ensuring adequate training that will hopefully lead to behavioral change is crucial to prevent breach in IPC and thus minimize the risk of exposure to and transmission of COVID-19 in healthcare facilities.
Fulltext Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations

Shah R, Agarwal A, Kavoussi P, Rambhatla A, Saleh R, Cannarella R, et al.

World J Mens Health, 2023 Jan;41(1):164-197.
PMID: 35791302 DOI: 10.5534/wjmh.220048

PURPOSE: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility.
MATERIALS AND METHODS: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field.
RESULTS: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available.
CONCLUSIONS: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.